Atch E - Time Sheet.xlsx
XLSX spreadsheet 13 KB Posted
- Attached to
- BIA Set-Aside: Pathology Physicians at PIMC
- Solicitation number
- RFQ-25-PHX-002
About this file
This document is a timesheet for contract services provided to the Phoenix Indian Medical Center (PIMC) under Contract Number 75H712. The timesheet requires the printed name, signature, and date of the Pathology Physician provider, along with a description of the hours worked (e.g., call-back, on-call, overtime, regular time). The timesheet must be verified by the Department Manager and approved by the Certified Contracting Officer's Representative (COR).
The related federal contract opportunity is for Pathology Physician Services at PIMC. This is a Buy Indian Act set-aside, meaning only companies that are at least 51% owned by a Native American or Alaska Native will be considered for award. PIMC requires a total of two candidates, one for a full-time position and one for a part-time position. Physicians must have completed a Pathology residency, hold an active and unrestricted medical license in Arizona or another U.S. state or territory, and be certified in BLS and ACLS. Proposals must be submitted to Jeremiah Murrell at the Indian Health Service by 3:00 PM EST on 11/11/2024.
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Text version
Sheet1
| PHOENIX INDIAN MEDICAL CENTER |
| STANDARD TIMESHEET FOR CONTRACT SERVICES |
CONTRACT NUMBER: 75H712 CONTRACTOR (Company Name)
PRINTED PROVIDER'S NAME:____________________________________ SERVICE PROVIDED: PATHOLOGY PHYSICIAN SERVICES
SIGNATURE OF PROVIDER: ___________________________________________________ DATE SIGNED: _____________________________
(Description of Hours: Call-Back, On-Call, Overtime, Regular Time, etc. - # Hours, Description of Hours, Hours Need to Match Invoice/Contract)
| WEEK OF _________________________________________ | |||||||
| Weekday | Date | Time IN | Lunch Out | Lunch In | Time OUT | Total Hours | Description of Hours |
| WEEK OF ________________________________________ | |||||||
| Weekday | Date | Time IN | Lunch Out | Lunch In | Time Out | Total Hours | Description of Hours |
VERIFIED BY Dept. Manager (Printed Name):_____________________________________ Signature: ___________________________________________________
APPROVED BY Certified COR (Printed Name):_____________________________________ Signature: __________________________________________________
File details come from the government source that posted it. Updated .